| NPI | 1104871177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 010272) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: LA 010272) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2008-05-30 |